Trigger finger and thumb

First line treatment is often by injection of steroid into the sheath but avoiding injection into the tendon itself. The GP can undertake this if happy to do so. This can be performed in clinic and often takes effect within one week. If symptoms recur the steroid injection can be repeated once or twice. Failure to respond or multiple recurrences are indications for surgical release of the A1 pulley. This can be performed as an outpatient local anaesthetic procedure through a small incision at the distal palmar crease and affords rapid recovery and relief of symptoms with a low recurrence rate.

Trigger digits in children is a completely different entity. They should be managed by a paediatric hand specialist. Trigger thumbs are very common and while trigger thumbs may resolve spontaneously (before the age of 2), there is a significant proportion that will not and would require treatment later on. Trigger fingers in children are very uncommon and would need to be assessed by an expert hand specialist

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